Table 3

Causes of elevated troponin values in clinical settings other than acute coronary syndromes or percutaneous coronary intervention

Ischaemic causes other than plaque fissuring or rupture
  • Coronary embolism (red cell or platelet thrombi, vegetation, atrial myxoma, calcification)

  • Coronary spasm

  • Coronary dissection

  • Aortic dissection

  • Transplant vasculopathy

Cardiac surgery
  • Left ventricular venting

  • Inadequate cardioplegia

  • Traumatic atrial cannulation

  • Manipulation of the heart

  • Ischaemia related causes such as conduit or native vessel occlusion

Miscellaneous
  • Tachyarrhythmia

  • Hypertension

  • Congestive heart failure

  • Renal failure

  • Drug toxicity (e.g. adriamycin, 5-fluorouracil, etc)

  • Hypothyroidism

  • Pulmonary embolism with right ventricular infarction

  • Sepsis (including sepsis occurring with shock)

  • Transient ischaemic attack, stroke or subarachnoid haemorrhage

  • Pheochromocytoma

  • Rhabdomyolysis with myocyte necrosis

Myopericarditis
  • Rheumatic fever

  • Rheumatoid arthritis

  • Systemic vasculitis

  • Post-viral

Infiltrative diseases of the myocardium
  • Amyloidosis

  • Sarcoidosis

Traumatic
  • Atrioventricular ablation

  • Defibrillation

  • Chest wall trauma